253 Vermont State Hospital patients, most with diagnosis of schizophrenia, some with primary affective disorders and other psychiatric disabilities were originally selected for chronic disability rehabilitated and released in the mid 1950's. A book about their program, "The Vermont Story" was published. A five year follow-up revealed 2/3rds of cohort were being effectively maintained in the community. A feasibility study has located 89% of the cohort. The work this grant period has been geared to revising a comprehensive design for a 20-year follow-up study. We are proposing a cross-sectional and longitudinal assessment of course and outcome of these probands, their children, and their grandchildren. The methodological improvements which have been made include: matched controls, longitudinal follow-backs, prospective follow-ups, specified diagnostic criteria, multivariate measures for outcome and structured interviews. Emphasis will be on buffers, family life, support systems and costs of formerly hospitalized patients, individual life history, predictors, and quality of life. Many claims and new scales and schedules are being planned and/or developed, such as SADS/RDC. The proposed procedure will include: field interviews with probands, children, grandchildren controls. Verification interviews with G.P.'s, important others, aftercare and vocational rehabilitation workers will be conducted. Work continues in the refinement of instruments and the completion of the Pilot Study.